Organization
CSI BEHAVIORAL COMPANY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VANGELA JAWAN HINES (CEO/OWNER)
(478) 278-6979
Entity
Organization
Contact information
Practice address
1528 TELFAIR ST, DUBLIN, GA 31021-3908
(478) 304-1244
(478) 304-1254
Mailing address
1528 TELFAIR ST, DUBLIN, GA 31021-3908
(478) 304-1244
(478) 304-1254
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
827333708A
—
GA
Enumeration date
05/18/2009
Last updated
09/22/2011
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